Does My Baby Really Need a Helmet?

I recently had an experience with... let’s just call them Big Helmet. During my son’s six-month appointment when his usual pediatrician was out, another doctor in the practice suggested that we take him for a free consultation to address the flatness in the back of his head. I definitely noticed this and had previously mentioned it to his doctor, but she assured me that it would most likely round out on its own. But because I will never not take a suggestion offered by my medical team, I scheduled the visit. It was free. What could it hurt? 

We arrived for our appointment time, filled out the necessary paperwork, and then were shuffled into a room where we waited to be taken for photos using a digital imaging machine. They put this tiny stocking cap on my son’s head—he looked like a sad little astronaut—and then took the 3D images that we would look at and further discuss with the occupational therapist we would be seeing that day.

As we started the discussion, the OT pulled up a video that juxtaposed the images of my son’s floating head next to a seemingly AI baby. She pointed out all of my son’s imperfections: His ears and cheeks are uneven, his head is growing wide but not long. She said I should have come in sooner. Feelings of shame and anxiety rushed through me. Her suggestion for treatment: My son would need a helmet for the next four months, worn 23 hours a day, with shaping appointments every two weeks. Then he would need another helmet after that, since he was already older than babies they usually see. I asked them if this would cause any harm to his development or brain growth and she said no.

When I asked about cost, she explained that treatment is not always covered by insurance. The out-of-pocket expense for their patented helmet can range anywhere from $1,500 to $3,800, and that’s not including copays, deductibles, and other costs that may come up. For those privileged enough to afford it and have a choice, that’s a lot to consider. For those who don’t have the resources, you’re left between a rock and a very guilty place.

This conversation and its ensuing diagnosis has become fairly common. Because parents are advised to lay infants on their back while sleeping to prevent SIDS, approximately one in five babies under the age of 6 months develops an imperfectly shaped skull. A study funded by the Netherlands Organisation for Health Research and Development found that infants with mild to moderate skull deformation did not inherently benefit from helmet therapy in a randomized controlled trial. A year later, however, a Chicago-based study of over 4,000 patients found that complete shape correction was achieved in 77.1 percent of patients who used conservative treatment (i.e., repositioning babies’ heads while they sleep) versus 94.4 percent in those first treated with helmet therapy, a fairly significant indicator that the therapy is effective. The contradictory studies are enough to make your head spin.

I left the appointment feeling completely deflated. They did everything but have The Hunchback of Notre Dame playing in the waiting room to make me feel like I’d horribly neglected my son and his skull. The way they presented information to me made it seem like I only had two options: Buy him this helmet or let him suffer with a deformed head for the rest of his life. I am not blind to my son’s head shape. I see it. I take doctors’ opinions and suggestions very seriously. I believe in science and all of the wonderful things it has to offer. It is entirely your choice when it comes to your child’s care and I respect those who opt for the helmet therapy sooner. And, of course, if your baby has an extreme case of skull deformation, you have every right to take that seriously and consult a pediatric or craniofacial surgeon. 

But I can’t help but think that this expensive helmet is just one more thing in a long line of products targeting vulnerable new parents, and specifically moms. It starts even before your baby is born, as you’re compiling your registry. If you don’t have the most expensive bassinet, your child won’t sleep. If you don’t have the fancy designer stroller, you’ll be ostracized. This fearmongering is used across the board in marketing campaigns to hit moms in the one place that will always be their weakness: their kids. 

I followed up with my son’s pediatrician, who told me it would be okay to wait it out a little longer and to see if his head shape will work out on its own, like my daughter’s had. For what it’s worth, that same Chicago study also found that complete correction was achieved in 96.1 percent of infants who received helmets after failed conservative therapy. In other words, there is time. My initial thoughts are that it will round out, since he’s sitting up now and sleeping primarily on his stomach, but I still can’t help but feel a twinge of guilt when I receive one of the many text messages (12 so far) urgently reminding me to get my son fitted for his helmet. I can’t stand the thought of him looking back and reading this some day with crooked glasses on his uneven ears and thinking his mom should have done better.

The decision right now is no decision, and I’m fortunate enough to be in a place where that is okay. I’ve learned that it’s fine to do some critical thinking, get a second opinion, and not take every suggestion at face value, especially when that suggestion is coming from someone who stands to gain financially. And most doctors trust that, even though you’re not shelling out thousands of dollars at the drop of a hat, you still care very deeply for your child. Believe me, I would cut off my own head and give it to my son if they asked me to—though it’s probably not perfectly round. 

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